Scans Show Brain Damage in Abused Teens

by John Gever John Gever,Senior Editor, MedPage Today
December 05, 2011

Action Points

This study suggests that advances in cognitive neuroscience allow scientists to begin to understand the manner by which childhood maltreatment affects subsequent psychopathology.

The study investigated the effects of childhood maltreatment on neuroimaging studies of gray matter volume in adolescents who did not meet criteria for a mental health disorder and found gender-based differences as well as differences in areas affected by different type of abuse.

Adolescents reporting a history of abuse -- even nonphysical forms such as emotional neglect -- had deficits in gray-matter brain volume in numerous regions compared with other teens, researchers said.

Among 42 teens without psychiatric diagnoses, scores on the self-reported Childhood Trauma Questionnaire were inversely correlated with gray-matter volume in brain regions including the prefrontal cortex, striatum, amygdala, and cerebellum, as well as cortical regions associated with sensory function, according to Hilary P. Blumberg, MD, of Yale University, and colleagues.

Moreover, the specific patterns of gray-matter deficit measured via high resolution MRI varied according to the type of abuse participants reported, the researchers indicated in the December issue of Archives of Pediatric and Adolescent Medicine:

Physical abuse: left dorsolateral and left rostral prefrontal cortices, right orbitofrontal cortex, right ventral striatum, right insula, and right temporal association cortex

There were also different patterns in boys versus girls related to abuse history, with girls tending to show atrophy in regions associated with emotional regulation, whereas in boys the deficits were concentrated in regions related to impulse control.

"Although adolescents with a history of childhood maltreatment may have symptoms and behaviors that may not yet meet criteria for psychiatric diagnoses, detection and early intervention may help improve functioning and reduce risk for the development of mood, addictive, and other psychiatric disorders," the researchers wrote.

An accompanying editorial by two University of Oregon researchers called the study important and recommended that additional neuroimaging studies be conducted to explore associations between child abuse and physical brain abnormalities.

"One particularly relevant new mind-set would consider the regional developmental trajectories of gray matter and white matter in a movement toward thinking about these effects at the level of networks rather than isolated regions," wrote Philip A. Fisher, PhD, and Jennifer H. Pfeifer, PhD.

They also suggested that follow-up studies examine functional as well as anatomical connectivity within the brain.

Blumberg and colleagues noted that adults with histories of childhood trauma have previously been found to have decreased gray-matter volume in the corticostriatal and limbic regions. However, the trajectory of these deficits over time had not been established; in particular, it was less clear whether they would already be evident during adolescence.

The sample was about equally divided between white and African-American teens 12 to 17 years old, including four with multiracial heritage. Participants were evaluated according to DSM-IV criteria for psychiatric conditions; only those not meeting criteria for any Axis I disorder were eligible for the study.

Individuals with a history of neurological disease, head trauma with loss of consciousness, or major medical disorder were excluded.

Limitations to the study included the small sample sizes for individual forms of abuse and the self-reports of abuse history, which did not indicate the individual's age at the time of abuse.

The National Institute of Mental Health (NIMH) and the National Institute on Drug Abuse (NIDA) funded the study, with additional support from the National Alliance for Research in Schizophrenia and Depression, Klingenstein Foundation, Women's Health Research at Yale, and Attias Family Foundation.

The writing of the editorial was supported by NIMH, NIDA, the National Institute of Child Health and Human Development, and the Department of Education.

Study authors and the editorialists reported they had no relevant financial interests.

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